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History of the Liverpool Teaching Hospitals until 1907

William Moss, a Liverpool surgeon, wrote a guide to Liverpool with the object of ventilating matters 'needing
attention' and mentions that the poorest people live overcrowded in cellars,
intemperate in habits and neglectful of their children. The expectation of life
in Liverpool in the early nineteenth century
was less than in most other places.

It was because of sugar imports that Liverpool
became the main centre of sugar refining. Liverpool became
wealthy and fortunes were made, amongst others, by the Gladstone
family, while in 1798 Pitt stated that of the overseas trade revenues no less
than four-fifths came from the West Indies.
Liverpool had surpassed Bristol because the
latter was not favorably placed; in the hinterland of Liverpool, Lancashire factories had grown apace during the
industrial revolution and they required an outlet for their goods. Lancashire
was building its 'dark, satanic mills'; Liverpool
was building its dark, satanic warehouses. Canal transport, booming in 1760,
had made conveyance of goods easier. In Britain, the earlier agricultural
revolution had improved food supplies and increased the population. All seemed
set fair. The increasing population necessitated a proper provision for the
sick so that the Ross Infirmary was opened by the 11th Earl of Derby in 1749.
Over the gate the following lines were inscribed:

Think while your hand th' entreated alms extend

That what to us ye
give-to God you lend.

The Infirmary and Seamen's Hospital with the
Medical Library on the extreme right, c.1813.

The first Infirmary stood on the site of the present day St
George's Hall, and cost £2,600 to build. It was expanded in 1771. The Infirmary
paid dividends even though it only contained fifty-four beds. It represented a
splendid act of charity on behalf of the citizens, but it was also a necessity
because ship-owners and others supported it to serve the needs of their
servants, sailors and dependants. In addition there was a Seaman's Hospital, or
rather hospice, under separate management, to care for sailors and their
families.

The old Infirmary was replaced in 1824 by a new hospital and lunatic asylum and was built on Brownlow Street and
renamed the Liverpool Royal Infirmary in 1851. The old Infirmary was closed in
1826 and eventually demolished in 1842 to make way for St George's Hall. The
one on Brownlow Hill was designed by John
Foster 'It was not his most inspired offering, its portico, six fluted columns
in dry, classical style pinioned by plastered antae, had a certain monumental
dignity'. This in turn gave way in 1887 to the present Gothic building designed
by Alfred Waterhouse. The original building did not please everyone including
John Aitken, one of its surgeons, who considered that the wards were dangerous
owing to overcrowding, but the trustees had reason to be thankful because all
debts had been paid off by 1752 and for the time being Liverpool's
problems were solved.

The second Infirmary, Brownlow Street, 1824-1890.

By a curious chance it was the slave trade that initiated
medical education in Liverpool and this was
done by men known as 'the African Surgeons'. In the eighteenth century medical
qualifications were variable, so that it was necessary for candidates for
surgical appointments in the Navy to submit to the examining board of the Company
of Surgeons in London.
An Act of Parliament was passed in 1789 compelling owners to carry a surgeon in
each ship. To select suitable men a licensing board was set up in Liverpool and it examined 634 surgeons between the years
1789 and 1807 rejecting no less than 151. The examinations were held at the
Infirmary monthly as required, successful candidates paying a fee of 3 guineas
with 5s.0d. for the secretary. Unsuccessful candidates paid 5s. 0d. only to the
secretary. Additional fees were levied if special examinations had to be
arranged. The following members of the Infirmary staff served on the
board-Joseph Brandreth, James Currie, James Gerard, Henry Park, John Lyon and
Edward Alanson. The Infirmary was taking pupils by permission of the Trustees although
the first recorded payment was in 1802. An improved education was becoming
necessary so that, as in London
and other towns, anatomy schools were founded to enable pupils of local doctors
and the Infirmary pupils to obtain a better preliminary training. Gill's and
Formby's Schools are mentioned in the Report from the Select Committee in
Anatomy (1828). There were about forty students, including sculptors, painters
and others besides medical students, studying at two schools, one in the charge
of Richard Formby and the other founded by William Gill, later surgeon to the NorthernHospital. According to Dyce Duckworth,
Formby never had a large practice nor was he a favorite with his brethren but
was of independent means and mainly interested in teaching. He had been a pupil
at the Infirmary before going up to Cambridge
in 1808.

Prior to the Anatomy Act there were scandals due to the
activity of the resurrectionists. Resurrectionists
were commonly employed by anatomists in the United Kingdom during the 18th and 19th centuries to exhume the bodies of the recently dead. Between 1506 and 1752
only a very few cadavers were available each year for anatomical research. The
supply was increased when, in an attempt to intensify the deterrent effect of
the death penalty, Parliament passed the Murder Act 1752. By allowing judges to
substitute the public display of executed criminals with dissection (a fate
generally viewed with horror), the new law significantly increased the number
of bodies anatomists could legally access. At one time bodies destined for Edinburgh, were shipped to Liverpool from Dublin. William Gill was implicated in
resurrectionist activity; the body of a young woman buried in Walton was found
in the cellar of a house which he owned in Seel Street. Gill was very fortunate to
be discharged by the magistrates. The schools required 24-28 bodies annually,
costing 3-7 guineas each.

Church Street in 1798, showing the Dispensary from 1782 to 1829.

Bodies were more easily procured from Dublin and they cost from 3-5 guineas each,
but they were liable to seizure by customs officials. From as early as 1811,
lectures were given at the Liverpool Dispensary, which had been built in Church Street in
1778. Sir Zachary Cope has pointed out that the Free Dispensaries played a
considerable part in medical education in Britain. Later the lectures were
given in the Royal Institution in Colquitt
Street.

In 1833, the physicians and surgeons of the Dispensary
required beds so that there was an agitation to found a new hospital, made
necessary because the Infirmary could no longer cope with the vastly increasing
population, particularly at the north end of the town. The result was the
founding of the NorthernHospital notably
supported by the reformed Council and men like Dr. James Carson, described as
'an old practitioner of the town'; William Brown, later Sir William, and a
distinguished Chairman of the Northern, was also involved.

The Northern Hospital, Great Howard Street, 1845-1900.

The David Lewis-Northern Hospital, Great Howard Street, 1900.

At a much later date, the Northern became the
first hospital in Europe to have its own ambulance, originated by Reginald
Harrison, one of Britain's
first urological surgeons, who wrote many pamphlets in its support. It cost
£227 a year to run and it cost the hospital more to hire the horse than to pay
its driver. 'The average time of each journey from call to return was 18
minutes 30 seconds' according to Harrison. A
houseman or a student had the duty of accompanying the driver and the ambulance
was equipped with drugs, splints, instruments (including a tracheotomy tube)
and dressings, so that the patient had intensive care from door to door. Of
course, prior to this patients were transported in a litter; but it should be
said that if you lived in Glasgow you could be taken to hospital in a sedan
chair, provided by the Royal Infirmary in 1794.

The Southern and Toxteth Hospital, Greenland Street, 1842-1872.

In 1842 it was necessary to build yet another hospital which
became the Royal Southern Hospital caring for the needs of the South end of the
town. It moved to a new building in 1872 and was recognized as a teaching
hospital by the Royal College of Surgeons in 1857 and by the Society of
Apothecaries in 1870, because it then had two physicians, which were required
by rule. In 1867 the city had again extended north into Kirkdale leading to the
establishment of the Stanley
hospital.

The Royal Southern Hospital, Caryl Street, 1872

Stanley Hospital

It is not by coincidence that the university backs on to Dover Street,
because it started simply as an extension of the MedicalSchool
and was built on the site of the Lunatic Asylum which had followed the
Infirmary up Brownlow hill in 1830. The beginnings of the university can be
traced back to 1876 when the MedicalSchool, owing to changes in the regulations of LondonUniversity,
required a lecturer in physics, so they appealed to the public for funds to
start endowments, a reasonable request considering the great public service
which it was rendering. It is interesting to note that Dr. James Carson as
early as 1836 urged the town council to found a university. A joint committee
with prominent local people decided to discuss with the Corporation the
formation of a university college. A chair of physics was endowed in 1880 and
the college received its charter in the following year. Combining with the
Leeds and Manchester colleges to form the VictoriaUniversity, it was possible to grant
degrees. The University
of Liverpool was granted
its' own charter in 1903. During all these years new departments were built and
new chairs endowed in medical and pre-medical subjects. It is significant that
the Statutes of the University make research obligatory. Towards the turn of
the century new minds, cultivated by the considerable advances of mid-Victorian
days, brought new ideas and a modern outlook for the millennium.

Liverpool University Victoria Building

The Northern, Southern, Eye and Ear Infirmary and the
Women's Hospital were all recognised by the university and the conjoint boards
in London and Scotland. K. W.Monsarrat, a
distinguished surgeon and teacher, persuaded these hospitals to combine to form
a ClinicalSchool,
which later in 1907 combined with the UniversityClinicalSchool, thereby
considerably widening the basis of clinical teaching and providing new scope.